Synapse - Detection of HER2-positive metastases in patients with HER2-negative primary breast cancer using 89Zr-trastuzumab PET/CT

Detection of HER2-positive metastases in patients with HER2-negative primary breast cancer using 89Zr-trastuzumab PET/CT Journal Article

Authors:	Ulaner, G. A.; Hyman, D. M.; Ross, D. S.; Corben, A.; Chandarlapaty, S.; Goldfarb, S.; McArthur, H.; Erinjeri, J. P.; Solomon, S. B.; Kolb, H.; Lyashchenko, S. K.; Lewis, J. S.; Carrasquillo, J. A.
Article Title:	Detection of HER2-positive metastases in patients with HER2-negative primary breast cancer using 89Zr-trastuzumab PET/CT
Abstract:	Our objective was to determine whether imaging with a human epidermal growth factor receptor 2 (HER2)-targeted PET tracer can detect HER2-positive metastases in patients with HER2-negative primary breast cancer. Methods: Patients with HER2-negative primary breast cancer and evidence of distant metastases were enrolled in an Institutional Review Board-approved prospective clinical trial. Archived pathologic samples from the patient's primary breast cancer were retested to confirm HER2-negative disease. Patients with confirmed HER2-negative primary breast cancer underwent 89Zr-trastuzumab PET/CT to screen for 89Zr-trastuzumab metastases. Metastases avid for 89Zr-trastuzumab by PET/CT were biopsied and pathologically examined to define HER2 status. Patients with pathologically proven HER2-positive metastases subsequently received off-protocol HER2-targeted therapy to evaluate treatment response. Results: Nine patients were enrolled, all of whom had pathologic retesting that confirmed HER2-negative primary breast cancer. Five demonstrated suggestive foci on 89Zr-trastuzumab PET/CT. Of these 5 patients, 2 had biopsy-proven HER2-positive metastases and went on to benefit from HER2-targeted therapy. In the other 3 patients, biopsy showed no evidence of HER2-positive disease, and their foci on 89Zr-trastuzumab PET were considered false-positive. Conclusion: In this proof-of-concept study, we demonstrated that 89Zr-trastuzmab PET/CT detects unsuspected HER2-positive metastases in patients with HER2-negative primary breast cancer. Although these are only initial results in a small sample, they are a proof of the concept that HER2-targeted imaging can identify additional candidates for HER2-targeted therapy. More specific HER2-targeted agents will be needed for clinical use. Copyright © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
Keywords:	breast; molecular imaging; oncology; trastuzumab; pet/ct; her2
Journal Title:	Journal of Nuclear Medicine
Volume:	57
Issue:	10
ISSN:	0161-5505
Publisher:	Society of Nuclear Medicine
Date Published:	2016-10-01
Start Page:	1523
End Page:	1528
Language:	English
DOI:	10.2967/jnumed.115.172031
PROVIDER:	scopus
PMCID:	PMC5050126
PUBMED:	27151988
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-84991300023&partnerID=40&md5=50f21419417fad7563379251f9f34f6e
Notes:	Article -- Export Date: 2 November 2016 -- Source: Scopus